Tonsils

Question 1

What is tonsillitis?

Answer 1

inflammation of the tonsils

Question 2

What are the common causative organism in tonsillitis?

Answer 2

Viruses - rhino/corona/parainfluenza

group A streps e.g. strep pyogenes

Question 3

What are complications of tonsillitis

Answer 3

otitis media
quinsy
rheumatic fever

Question 4

What are indications of tonsillectomy?

Answer 4

if person meets all criteria:

• sore throats are due to tonsillitis
• ≥5 sore throat a yr
• sx have been occurring for at least a year
• episodes disabling + preventing normal functioning

Question 5

what are other indications to tonsillectomy not relating to sore throat?

Answer 5

• recurrent febrile convulsions due to T
• OSA, stridor or dysphagia 2o to enlarged tonsils
• quinsy if unresponsive to standard rx

Question 6

What are complications of tonsillectomy?

Answer 6

haemorrhage and pain

Question 7

what is non-surgical rx of tonsillitis?

Answer 7

paracetamol +/- difflam

abx - most are viral but penicillin if ill or centor +ve

Question 8

what is the Centor criteria used for?

Answer 8

method to quickly diagnose the presence of Group A streptococcal infection or diagnosis of streptococcal pharyngitis in adults complaining of sore throat

Question 9

what are the criteria involved in centor criteria? what score indicates a high chance of s pyogenes

Answer 9

• presence of tonsillar exudate
• tendon anterior cervical lymphadenopathy
• Hx of fever
• absence of cough
  3 or more

Question 10

What is quinsy also known as?

Answer 10

peritonsillar abscess

Question 11

how does quinsy present?

Answer 11

sore throad
dysphagia
peritonsillar bulge
ulnar deiation
trismus 
muffled voice

Question 12

what is trismus

Answer 12

reduced opening of jaw

Question 13

what is the rx of quinsy?

Answer 13

abx

aspiration

Question 14

what are retropharyngeal abscesses?

Answer 14

abscess located in the tissues in the back of the throat behind the posterior pharyngeal wall

Question 15

what is the typical presentation of retropharyngeal abscess? what ix would u do? what would it show?

Answer 15

ill child w stiff, extended neck who fails to eat or drink

Lateral neck XR - soft tissue swelling

Question 16

wHat is the rx of retropharyngeal abscess?

Answer 16

incise and drain pus under GA

Question 17

what is lemierres syndrome?

Answer 17

infectious thrombophlebitis of the internal jugular vein.

Question 18

What are the complications of tonsillitis?

Answer 18

1. Quinsy
2. Retrophayrngeal abscess
3. Para/hypopharyngeal abscess
4. Lemierres syndrome

Question 19

What are DD for unilateral tonsillar enlargement?

Answer 19

Malignancy

Peritonsillar abscess

Question 20

What can tonsillitis caused by strep progenies develop into? how would u know? what is rx?

Answer 20

SCARLET FEVER 
Rash on chest, axillae or behind the ears 12-48hrs after initial infection 
Circumoral pallor 
Strawberry tongue 
rx: penicillin